| NPI | 1366056434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 025640-01) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2022-06-21 |