| NPI | 1225168065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 9313) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 2003) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2019-10-28 |