| NPI | 1003332628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 021140) |
| Additional Taxonomies | 208800000X Urology (Licence: NY 021140) |
| 363A00000X Physician Assistant (Licence: NY 021140) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2020-09-22 |