| NPI | 1609263920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5360) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2026-01-20 |