| NPI | 1750702213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 2034) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2026-06-02 |