| NPI | 1952610222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 9286) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC 1801) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 0014235) | |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2024-07-30 |