| NPI | 1518961218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103055) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 10941) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2021-12-08 |