| NPI | 1841542693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058062) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015870-1) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA5014) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2016-03-11 |