| NPI | 1124416003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018210) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2021-01-17 |