| NPI | 1700488764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2020009581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113273) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2022-05-17 |