| NPI | 1982423174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-14938) |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2025-01-20 |