| NPI | 1922344241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 23016245) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106690) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2018-03-17 |