| NPI | 1003207101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-04-20 |