| NPI | 1518183482 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C03369) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003369) | 
| Enumeration Date | 2007-04-18 | 
| Last Update Date | 2014-10-07 |