| NPI | 1689286023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118293) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9971) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2024-08-13 |