| NPI | 1427203892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054439) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012690-1) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2020-12-30 |