| NPI | 1699968602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108703) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011753) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2024-02-27 |