| NPI | 1184666935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9100958) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008795-1) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-11-25 |