| NPI | 1851728455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08099) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10001588A) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2018-07-31 |