| NPI | 1568236313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9121081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13748) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2026-04-20 |