| NPI | 1518338516 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109037) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010541) | 
| Enumeration Date | 2015-10-15 | 
| Last Update Date | 2025-06-03 |