| NPI | 1245331180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9109513) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011147) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-07-21 |