| NPI | 1407153299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 014223) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 002423) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2013-04-17 |