| NPI | 1235192808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA054384) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0001458) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2013-07-09 |