| NPI | 1184094203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018642) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2023-03-21 |