| NPI | 1932702321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA005556) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA062326) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2023-06-23 |