| NPI | 1558950691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 60618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114156) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2023-08-30 |