| NPI | 1255347191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL pa9115942) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012735) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-05-11 |