| NPI | 1558074013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116874) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009203) |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2025-09-17 |