| NPI | 1972809416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118515) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 01100027863) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2025-05-07 |