| NPI | 1386778363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06831) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000553) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2018-12-03 |