| NPI | 1497210314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111713) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 367H00000X Anesthesiologist Assistant (Licence: FL 9111713) | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-09-07 |