| NPI | 1588934814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017126) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106303) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2024-02-26 |