| NPI | 1073602686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 009713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009027) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2025-07-17 |