| NPI | 1730197773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9105115) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-11-09 |