| NPI | 1952610461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9109681) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 014892) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2019-08-27 |