| NPI | 1841875895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID PA-2037) |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2024-05-09 |