| NPI | 1962178616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0567) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2577) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2022-08-12 |