| NPI | 1215313903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 1126818) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200846) |
| 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200846) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2025-11-26 |