| NPI | 1114097862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 011273-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 11273) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2023-07-07 |