| NPI | 1689149692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022723) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2023-03-02 |