| NPI | 1457915084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9119063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9119063) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2025-05-20 |