| NPI | 1700275088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9111944) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 001844-1) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2020-02-27 |