| NPI | 1083852370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 2550) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA056652) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002597) | |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2018-03-09 |