| NPI | 1598172801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 017699-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3137) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00344500) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2018-03-17 |