| NPI | 1497934129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 6654) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012074) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2013-06-07 |