| NPI | 1679098701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021157) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2026-04-23 |