| NPI | 1083263065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116024) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2022-06-15 |