| NPI | 1609637982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 031557-01) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2025-10-14 |