| NPI | 1366239527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9121615) |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2026-07-17 |