| NPI | 1497596159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118854) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL 9118854) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-10-01 |