| NPI | 1942335492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104589) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011476) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2022-01-14 |