| NPI | 1871763094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105875) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012444-1) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2024-01-16 |