| NPI | 1023593233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111589) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2025-02-03 |