| NPI | 1245570944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1649) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107073) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2017-01-17 |