| NPI | 1518277920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NY 014394) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT 003164) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2023-11-06 |