| NPI | 1174853808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 013261) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013261) |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2015-07-07 |