| NPI | 1487321790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117592) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027274-01) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2023-10-26 |