| NPI | 1528505070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2237) |
| 363A00000X Physician Assistant (Licence: IA 085452) | |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2022-05-04 |