| NPI | 1407246630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9117261) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 023494-1) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-05-08 |