| NPI | 1811022445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010682) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010682) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2025-01-07 |