| NPI | 1811324791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0011485) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 017074) |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2021-01-14 |