| 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 |