| NPI | 1396286902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005571) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C06415) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2025-02-10 |