| NPI | 1053930842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116267) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2025-04-25 |