| NPI | 1477300291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 2102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL TPPA724) |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-06-19 |