| NPI | 1427772375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9117599) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2023-09-01 |