| NPI | 1710865423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL TPPA1007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 2676PA) |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-23 |