| NPI | 1447895370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 033217) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2026-06-25 |