| NPI | 1952925653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113016) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113016) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2022-05-13 |