| NPI | 1841215464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4580) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008887) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-04-25 |