| NPI | 1447837828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114960) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-04-20 |