| NPI | 1386504967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL TPPA1172) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 2818-P.A.) |
| Enumeration Date | 2025-11-14 |
| Last Update Date | 2026-03-20 |