| NPI | 1538162292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107934) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA12495) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2016-03-24 |