| NPI | 1316902398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02822) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA051444) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2014-08-25 |