| NPI | 1679273601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6308) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117074) |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2025-03-24 |