| NPI | 1619105996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105446) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2013-09-24 |