| NPI | 1770699324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006718) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9102896) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA56715) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-09-05 |