| NPI | 1063857183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 246zc0007x) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2018-10-30 |