| NPI | 1689273161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 12444) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113762) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2025-07-10 |