| NPI | 1902385321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022468) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2023-04-19 |