| NPI | 1487060471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111088) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 017650) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2018-07-30 |