| NPI | 1407174824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106567) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA58724) |
| 363A00000X Physician Assistant (Licence: NY 012376) | |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2021-10-01 |