| NPI | 1396257457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 024475) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-006417) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2021-04-22 |