| NPI | 1023868767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5932) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-05-15 |