| NPI | 1164960340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111997) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005667) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2025-08-11 |