| NPI | 1629809447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119018) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-10-13 |