| NPI | 1497277347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059089) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004175) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-12-20 |