| NPI | 1164273843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 722) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 2092-P.A.) |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-06-25 |