| NPI | 1376194720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 024259) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2024-03-16 |