| NPI | 1124088851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 6370) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: AZ 3344) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2017-02-01 |