| NPI | 1366505786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA2762) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009065) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2025-06-12 |