| NPI | 1770796625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009719-1) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00122900) | |
| 363L00000X Nurse Practitioner (Licence: FL PA9115496) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-02-23 |