| NPI | 1518179332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 000682-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 000682-1) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |