| NPI | 1528112729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2012006732) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MS PA00096) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-05-12 |