| NPI | 1447363379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA30174) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002373) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-07-13 |