| NPI | 1700105467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 002492-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 002492-1) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2020-02-06 |