| NPI | 1568007656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005554) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063371) |
| 363A00000X Physician Assistant (Licence: CA 57442) | |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2024-07-25 |