| NPI | 1821220815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109371) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013401) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2021-05-12 |