| NPI | 1528585395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8644) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008644) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2019-12-20 |