| NPI | 1508230343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057969) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003675) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2021-06-14 |