| NPI | 1912593575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025535) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 025535) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2021-01-12 |