| NPI | 1730739475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-09333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09333) |
| Enumeration Date | 2019-09-15 |
| Last Update Date | 2025-02-11 |