| NPI | 1740505940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017768) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105142) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2017-11-03 |