| NPI | 1578318960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC MPA.5236) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9118484) |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |