| NPI | 1164614384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 0127041) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA 60270956) |
| Enumeration Date | 2007-08-11 |
| Last Update Date | 2018-05-04 |