| NPI | 1467175620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4577) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116397) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |