| NPI | 1588696413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 075825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 878) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-01-08 |