| NPI | 1316142599 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 011892)  | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2007-06-18 | 
| Last Update Date | 2021-02-10 |