| NPI | 1841885019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114004) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066868) |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2025-11-19 |