| NPI | 1013229806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106627) |
| 363A00000X Physician Assistant (Licence: NY 014040) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2022-05-05 |