| NPI | 1447212162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60995158) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9101661) |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10002582A) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2019-10-15 |