| NPI | 1801368964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111928) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2021-07-01 |