| NPI | 1295743847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002656) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA052610) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-03-12 |