| NPI | 1780773341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010467) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10231) |
| 363A00000X Physician Assistant (Licence: FL PA9104967) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2021-03-25 |