| NPI | 1447554274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 014092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014092) |
| 363A00000X Physician Assistant (Licence: FL PA9105848) | |
| Enumeration Date | 2011-01-09 |
| Last Update Date | 2014-09-30 |