| NPI | 1063753705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108837) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016352) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2022-06-06 |