| NPI | 1659043925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029359) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL PA9115070) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2023-01-09 |