| NPI | 1144894460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4438) |
| 363A00000X Physician Assistant (Licence: FL PA9112298) | |
| 363A00000X Physician Assistant (Licence: SC PA3980) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-07-15 |