| NPI | 1912376799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 022476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057839) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2023-05-18 |