| NPI | 1275891426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL 1162) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106512) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-07-16 |