| NPI | 1528621885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033803-01) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9112202) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-10-21 |