NPI | 1831800218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PACN68) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 2295PA) |
171M00000X Case Manager/Care Coordinator (Licence: FL 0105383) | |
Enumeration Date | 2022-12-07 |
Last Update Date | 2025-07-16 |