| NPI | 1467893164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016693) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2017-10-04 |