| NPI | 1932758265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2562) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 1162973) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2023-04-25 |