| NPI | 1972599272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110008984) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0001974) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2025-02-28 |