| NPI | 1447534821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-1418) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4916) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 4916) | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2018-11-16 |