| NPI | 1740988401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PR 001285-P.A.) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: NY 18-121) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-21 |