| NPI | 1649203233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018044) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-09-17 |