| NPI | 1144376054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011440) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA20222) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-03-11 |