| NPI | 1720434897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9109055) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2020-12-16 |