| NPI | 1013450956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109719) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9242) |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2023-05-12 |