| NPI | 1952072555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0008220) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2025-02-18 |