| NPI | 1386944643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058276) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 009835) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2020-10-06 |