| NPI | 1780079517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018506) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-03-14 |