| NPI | 1922773720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10717) |
| 363A00000X Physician Assistant (Licence: NC 0010-11838) | |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2024-07-15 |