| NPI | 1013990712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 102585) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2009-05-18 |