| NPI | 1699804831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 017520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017520) |
| 363A00000X Physician Assistant (Licence: FL PA9104052) | |
| 363A00000X Physician Assistant (Licence: NY 17520) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-07-03 |