| NPI | 1467500231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2088) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 2088) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-10-05 |