| NPI | 1669100608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PACN77) |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2025-09-10 |