| NPI | 1114385069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118699) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2016-0102) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 027427) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2024-08-26 |