| NPI | 1831800218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL TPPA830) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: FL 0105383) |
| 363A00000X Physician Assistant (Licence: PR 2295PA) | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2024-12-17 |