| NPI | 1548736960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1827) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 1827) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2024-04-24 |