| NPI | 1003129107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15208) |
| 363A00000X Physician Assistant (Licence: NY 029470) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2026-07-16 |