| NPI | 1407500986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12840) |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2026-07-23 |