| NPI | 1598112062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NV PA2010) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: CA 53766) |
| Enumeration Date | 2016-05-15 |
| Last Update Date | 2019-02-22 |