| NPI | 1306228101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 9112052) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 018702) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-05-24 |