| NPI | 1104826130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 1531023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 1531023) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2007-07-08 |