| NPI | 1053719187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 018222) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 018222) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2019-11-01 |