| NPI | 1811453749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111890) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08935) |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2023-07-23 |