| NPI | 1245805092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9114059) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL PA9114059) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2024-09-11 |