| NPI | 1467065045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9114756) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114756) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 025585) | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2024-10-14 |