| NPI | 1548875347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61428) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 025612) |
| 363A00000X Physician Assistant (Licence: NY 025612) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 025612) | |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2023-10-25 |