| NPI | 1174764534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60152507) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50002882) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2013-10-09 |