| NPI | 1629758727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15712) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9117863) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2026-08-14 |