| NPI | 1457924706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118738) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 313430) |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2026-01-21 |