| NPI | 1679897011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 1091482) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL pa9114048) |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2023-03-30 |