| NPI | 1346919123 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114990) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2021-09-07 | 
| Last Update Date | 2023-01-18 |