| NPI | 1639995921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119561) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9119561) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-09 |