| NPI | 1699329912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112473) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2022-05-06 |