| NPI | 1598426280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C09225) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA117895) |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2024-01-26 |