| NPI | 1487369047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 031590) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0009306) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00842100) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9117092) | |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2024-10-09 |