| NPI | 1124421995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018095) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 018095) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2017-12-06 |