| NPI | 1063844199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016793) |
| 363A00000X Physician Assistant (Licence: FL 9107325) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2022-08-16 |