| NPI | 1922554609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111396) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020227) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2020-09-02 |