| NPI | 1346575313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014699-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105143) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2021-03-25 |