| NPI | 1336697929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030836) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005886) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2023-12-27 |