| NPI | 1003847377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 010734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010734) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-05-01 |