| NPI | 1407251671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 003549) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 018208) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2016-07-21 |