| NPI | 1932594538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018413) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-04-04 |