| NPI | 1619023470 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant | 
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL PA9103463)  | 
| Enumeration Date | 2007-01-26 | 
| Last Update Date | 2019-06-25 |