| NPI | 1477167476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115346) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY PA031775) |
| Enumeration Date | 2020-09-07 |
| Last Update Date | 2025-10-15 |