| NPI | 1750837837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109920) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 1124327) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2017-04-18 |