| NPI | 1235988551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120126) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008581) |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2025-09-15 |