| NPI | 1831398056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA00224) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2024-05-30 |