| NPI | 1497785984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 024590) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 9302) |
| 363AS0400X Physician Assistant, Surgical (Licence: MN MN9302) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-01-30 |