| NPI | 1558754713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 018329) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2017-03-15 |