| NPI | 1083412332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1215677) |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-05-22 |