| NPI | 1154833978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114885) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021573) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2022-02-11 |