| NPI | 1154373371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2010042898) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 1400) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2014-10-07 |