| NPI | 1992325930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023013212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115193) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-07-06 |