| NPI | 1245427400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01567) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 011773) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2014-12-09 |