| NPI | 1831522382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 016741-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 016741-1) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2019-04-02 |