| NPI | 1689350332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 3227) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 130808) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-03-24 |