| NPI | 1578602850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008341) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY MA 008341) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2025-01-08 |