| NPI | 1982013330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117635) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017856) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2023-11-09 |