| NPI | 1386895522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA156128) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012844) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2012-03-27 |