| NPI | 1902556053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116456) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2023-03-27 |