| NPI | 1255001574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117572) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027150) |
| 363L00000X Nurse Practitioner (Licence: NY 27150) | |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2023-07-17 |