| NPI | 1184656795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NY 012334) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA052360) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-12-12 |