| NPI | 1245702026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9119243) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006819) |
| 363A00000X Physician Assistant (Licence: WA PA61276656) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2025-04-10 |