| NPI | 1942926746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9116658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116658) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2024-10-04 |