| NPI | 1346726866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006884) |
| 363A00000X Physician Assistant (Licence: FL PA9117538) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 022246) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 022246) | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2023-07-13 |