| NPI | 1992002190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02825) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2020-10-25 |