| NPI | 1215011440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 005338) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA464) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-02-24 |