| NPI | 1649576950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014582) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2025-08-19 |