| NPI | 1366527822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115234) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06015) |
| 363A00000X Physician Assistant (Licence: CT 000177) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2025-08-24 |