| NPI | 1720827801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: FL PN5242498) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-09-10 |