| NPI | 1235263450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103255) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 015151) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-02-15 |