| NPI | 1861174211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL pa9116865) |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2024-01-08 |