| NPI | 1013654656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115967) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA2527) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2025-07-17 |