| NPI | 1801533823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116176) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2025-04-07 |