| NPI | 1679341754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030381) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-10-23 |