| NPI | 1841748456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 020501-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3667) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2017-02-17 |