| NPI | 1659266385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9120561) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-11-13 |