| NPI | 1316275332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA 200551) |
| 363AS0400X Physician Assistant, Surgical (Licence: LA 200551) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2015-11-05 |