| NPI | 1629782461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9116923) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: FL 9116923) | |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2024-01-02 |