| NPI | 1306904966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C03923) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 1070062) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-03-08 |