| NPI | 1467693572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109521) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3734) |
| 363A00000X Physician Assistant (Licence: NY 016353) | |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2016-07-21 |