| NPI | 1598877151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 677) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NY 004946-1) | |
| 363A00000X Physician Assistant (Licence: FL PA9104420) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-09-06 |