| NPI | 1730414731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 015474) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10004706A) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2025-02-26 |