| NPI | 1326795642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115658) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2025-07-06 |