| NPI | 1881395044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10340) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL TPPA543) |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2024-05-30 |