| NPI | 1992323935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1174437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11811) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2024-12-09 |