| NPI | 1023232840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008879) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2023-06-22 |