| NPI | 1053400697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 005542-1) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 5951647-1206) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2019-01-04 |