| NPI | 1235884305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12781) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115696) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2025-02-03 |