| NPI | 1982298253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9117465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117465) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2023-05-31 |