| NPI | 1245389253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 003858) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 1000225) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-04-11 |