| NPI | 1124008602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 3765) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113435) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2025-05-08 |