| NPI | 1700567690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2970) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: 2970) |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2025-04-03 |