| NPI | 1366724932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 014906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014906) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 014906) | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |