| NPI | 1487765475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 003809-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 0003809-1) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-02-21 |