| NPI | 1730633967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006496) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2025-07-29 |