| NPI | 1871975995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06339) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9109738) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2025-06-24 |