| NPI | 1639157258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104533) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 010848) |
| 363A00000X Physician Assistant (Licence: NY 010848) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2014-02-13 |