| NPI | 1245538990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4494) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 0819) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2018-10-02 |