| NPI | 1871198960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PACN106) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 864-P.A.) |
| 207Q00000X Family Medicine (Licence: FL TPME1146) | |
| 207Q00000X Family Medicine (Licence: NJ NJDCATEMP-037226) | |
| 208D00000X General Practice (Licence: FL HSE36437) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL TPPA672) | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2025-10-23 |