| NPI | 1689851537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA-9106461) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012338) |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2010-0045) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2023-06-19 |