| NPI | 1972186237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL PA9116910) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116910) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2023-07-11 |