| NPI | 1689206781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 024862-01) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2025-04-14 |