| NPI | 1780330373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115136) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 6030) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2025-01-25 |