| NPI | 1619420866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112617) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 003356) |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2020-02-05 |