| NPI | 1881118735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 020993) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA55599) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2019-10-21 |