| NPI | 1063057347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 024463) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 024463) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2020-07-09 |