| NPI | 1679582936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0005669) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000418) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-07-22 |