| NPI | 1033168463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 004885) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004885) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-09-19 |