| NPI | 1083811053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 12213) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-09-29 |