| NPI | 1871898312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: HI AMD 601) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 006009) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2018-10-19 |