| NPI | 1205255080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9119780) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017195-1) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2025-05-09 |