| NPI | 1164702981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA054920) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2015-06-03 |