| NPI | 1417456799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111286) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021785) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2023-03-06 |