| NPI | 1831440767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002986) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055774) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2016-09-16 |