| NPI | 1811991573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 274260) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 005596) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2014-04-30 |