| NPI | 1851132765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PACN51) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR P.A-001987) |
| 363A00000X Physician Assistant (Licence: FL TPPA738) | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-05-22 |