| NPI | 1487075008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 61073) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2025-08-24 |