| NPI | 1528326907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115142) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006370) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115142) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2024-07-10 |