| NPI | 1942979661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011264) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114969) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2025-12-05 |