| NPI | 1609579861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024006370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117112) |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-05-21 |