| NPI | 1821738444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5731) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-11-15 |