| NPI | 1073129334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117001) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027445) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9117001) | |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2024-05-22 |