| NPI | 1346579125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117803) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015371) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2023-09-08 |