| NPI | 1649675786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022112-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108328) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2021-02-05 |