| NPI | 1497153274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108371) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL FK0578229) |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2025-12-15 |