| NPI | 1649756537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022233) |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2021-01-20 |