| NPI | 1649581331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02382) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9016093) | |
| 363AM0700X Physician Assistant, Medical (Licence: GA 006061) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2022-12-29 |