| NPI | 1134558802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110288) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017180) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2018-03-17 |