| NPI | 1497375075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9114785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 7885) |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2024-01-04 |