| NPI | 1851966261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 026684) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2022-04-21 |