| NPI | 1003785353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 034968) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 034968) |
| Enumeration Date | 2025-11-04 |
| Last Update Date | 2026-02-06 |