| NPI | 1740891357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4149) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1868) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2022-09-06 |