| NPI | 1730591264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA3328) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004445) |
| 363A00000X Physician Assistant (Licence: NY 004939-1) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |