| NPI | 1245466580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 016493) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030595) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2013-09-05 |