| NPI | 1578126942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113293) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2022-05-31 |