| NPI | 1396158598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 017114-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017114-1) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00325100) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-10-08 |