| NPI | 1376710541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115617) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115617) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 5317) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2025-09-18 |