| NPI | 1912738097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119677) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119677) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2025-04-03 |