| NPI | 1164076691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 023747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023747) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-05 |