| NPI | 1366991754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020130) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 020130) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2017-01-31 |