| NPI | 1871182824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113961) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 13332) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2025-08-26 |