| NPI | 1134599327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059086) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 019151) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2023-11-08 |