| NPI | 1538223888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 174400000X Specialist (Licence: KY SA046) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2014-11-03 |