| NPI | 1487276069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9252) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113085) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2023-03-10 |