| NPI | 1669208773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9119530) |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-10-28 |