| NPI | 1629160866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 008924) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103231) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-11-27 |