| NPI | 1346419652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 7456) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051283) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2016-05-02 |