| NPI | 1326270067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 013214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013214-1) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2016-12-28 |