| NPI | 1487813465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD PA030536) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001005631) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2019-11-05 |