| NPI | 1740451319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107679) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 12198) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2023-08-11 |