| NPI | 1265149165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA213471) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2026-05-29 |