| NPI | 1447295662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 009373) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9562) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-02-21 |