| NPI | 1073109963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114395) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: FL PA9114395) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2024-01-17 |