| NPI | 1437728912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12885) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114665) |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner (Licence: NC 001012885) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2024-02-27 |