| NPI | 1093142770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9207) |
| 363AS0400X Physician Assistant, Surgical | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 032096) | |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2025-04-15 |