| NPI | 1952914996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025150) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 025150) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-11-18 |