| NPI | 1245991272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115267) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027790-01) |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2022-01-18 |