| NPI | 1265976237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 101672111206) |
| Enumeration Date | 2016-12-11 |
| Last Update Date | 2025-06-09 |