| NPI | 1326112939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 011603-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2553) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 11603) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-03-21 |