| NPI | 1063792901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032564) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105456) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2025-07-03 |