| NPI | 1144409103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110004222) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C03660) |
| 363AS0400X Physician Assistant, Surgical (Licence: MT 655) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2013-05-17 |