| NPI | 1801143599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA200553) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2016-06-28 |