| NPI | 1467617688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105079) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012567) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2021-01-28 |