| NPI | 1689111684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 020787-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA60838) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110072) | |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2026-07-11 |