| NPI | 1346373396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 003438) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 003438) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-05-13 |