| 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 |