| NPI | 1104959931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004154) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-04-30 |