| NPI | 1215054630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000525) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA052669) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 008557-1) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2015-09-10 |