| NPI | 1568103885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9116568) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2022-09-29 |