| NPI | 1306179825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9109566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006748-1) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2017-03-06 |