| NPI | 1982297248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SD 1284) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 107353) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-02-18 |