| NPI | 1073880324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007844) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 015-341) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2016-03-22 |