| NPI | 1639520810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109602) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9109602) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 031902) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-09-13 |