| NPI | 1558836544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 022717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022717) |
| 363A00000X Physician Assistant (Licence: NY 22717) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 022717) | |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2023-06-30 |