| NPI | 1790376119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MO 2022929748) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02663) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2023-06-22 |