| NPI | 1952526329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105412) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 009672) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2012-10-15 |