| NPI | 1336685155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010632) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2023-10-09 |