| NPI | 1114152329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MAO55689) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MD R185137) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2013-09-27 |