| NPI | 1528165537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011374-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106521) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 011374-1) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-03-27 |