| NPI | 1215174099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008946) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25mp00101800) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-03-30 |