| NPI | 1336542554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 017911) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2015-07-18 |