| NPI | 1245279520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104653) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009409) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2015-04-03 |