| NPI | 1801852777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 006387-1) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2011-12-23 |