| NPI | 1730574708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PT1524) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 175078) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-02-17 |