| NPI | 1003686932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9119188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1482) |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-09-27 |