| NPI | 1396889127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109641) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009214) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2021-03-15 |