| NPI | 1497348155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10854) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000004359) |
| 363A00000X Physician Assistant (Licence: FL PA9113714) | |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2025-12-15 |