| NPI | 1215168448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110003636) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2015-01-12 |