| NPI | 1972806339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11679) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2026-01-28 |