| NPI | 1245378207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C02974) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030383) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2009-04-22 |