| NPI | 1447429881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012404-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1319) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9106118) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106118) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2014-03-04 |