| NPI | 1265147375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9116849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9119849) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2025-02-13 |