| NPI | 1437458163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA159529) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-02434) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2020-10-27 |