| NPI | 1598185043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0974) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2060) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-01-30 |