| NPI | 1003221714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113214) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NY 017479) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 017479) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2023-08-22 |