| NPI | 1245488113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114642) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0126381) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2024-07-11 |