| NPI | 1518102599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 013049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013049) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2016-12-29 |