| NPI | 1780810325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013276) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 013276) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-07-15 |