| NPI | 1881235752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 024507) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4678) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2023-05-11 |