| NPI | 1629303953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-397) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR PA-397) |
| 363AM0700X Physician Assistant, Medical (Licence: AR PT0928) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2024-04-29 |