| NPI | 1235411745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA92105567) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2021-01-04 |