| NPI | 1740992593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6295) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117185) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2025-01-22 |