| NPI | 1487703492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102427) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 102427) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2018-01-23 |