| NPI | 1902924897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103630) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010926) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-01-22 |