| NPI | 1811103971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109387) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011686) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2017-12-18 |