| NPI | 1912328360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05744) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085004944) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10001593A) | |
| Enumeration Date | 2014-01-01 |
| Last Update Date | 2025-07-11 |