| NPI | 1699163238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 3129) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 018243) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2021-03-08 |