| NPI | 1326835323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 7162) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 035767) |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2026-04-17 |