| NPI | 1982396446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9117400) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-08-09 |