| NPI | 1972067791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111749) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2024-08-28 |