| NPI | 1629847298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PACN44) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1826) |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2025-05-22 |