| NPI | 1790896165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116796) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 004670) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-01-23 |