| NPI | 1134674120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113359) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2025-10-09 |