| NPI | 1922357086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 015905) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 004549) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2021-04-15 |