| NPI | 1275792095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MD C06660) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: IN 10001110A) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2018-03-17 |