| NPI | 1588036743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C007965) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057976) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2024-10-04 |