| NPI | 1770289779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL TPPA737) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 1548-P.A.) |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2024-07-17 |