| NPI | 1912673252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL PA9114980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114980) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2026-03-03 |