| NPI | 1053042333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 1195996) |
| Enumeration Date | 2022-06-18 |
| Last Update Date | 2022-11-08 |