| NPI | 1720643737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 47878) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2022-06-27 |