| NPI | 1285350223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14967) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117159) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-01-22 |