| NPI | 1013651603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5973) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9115843) |
| 363AS0400X Physician Assistant Surgical (Licence: FL PA9115843) | |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2024-07-17 |