| NPI | 1235530320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102588) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 008172) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |