| NPI | 1831684158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022155) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2020-09-17 |