| NPI | 1891334389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10261) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 4223) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2021-10-05 |