| NPI | 1326040916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 0851) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 001390) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2011-10-18 |