| NPI | 1114019940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C50000137) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C50000137) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-05-20 |