| NPI | 1265493191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005222) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2024-01-31 |