| NPI | 1134381197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104596) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY PA9104596) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2012-07-25 |