| NPI | 1275194573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023602) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 1148994) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-05-12 |