| NPI | 1144740283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 312979) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-04-29 |