| NPI | 1447313010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OR PA130018) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NH 0614) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-09-24 |