NPI | 1205118031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015061-1) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 15061) |
Enumeration Date | 2011-09-19 |
Last Update Date | 2024-04-03 |