| NPI | 1295894913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: PA MA055995) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17286) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2013-07-15 |