NPI | 1356997787 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 101085) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 023819) |
Enumeration Date | 2019-08-12 |
Last Update Date | 2025-07-14 |