| NPI | 1124676580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117749) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9269) |
| 363A00000X Physician Assistant (Licence: NY 025755) | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2025-06-08 |