| NPI | 1811639008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1177614) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AR PT2022-061) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-11-08 |