| NPI | 1861778664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107705) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0150391) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2021-03-16 |