| NPI | 1265983548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9109849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023059) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2024-09-13 |