| NPI | 1477420107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 034791) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 034791) |
| 208600000X Surgery (Licence: NY 034791) | |
| Enumeration Date | 2025-10-17 |
| Last Update Date | 2025-10-17 |