| NPI | 1851337273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007629) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA NA 050936) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-04-05 |