| NPI | 1942591193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013064-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 013064-1) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2017-04-28 |