| NPI | 1124377338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-1257) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2015-09-08 |