| NPI | 1154406031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011459) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011459) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-12-19 |