| NPI | 1003992629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 2152) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 2152) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA 2152) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-10-20 |