| NPI | 1609236363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06127) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2018-06-08 |