| NPI | 1932509171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: PA MA057124) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2023-01-02 |