| NPI | 1538337720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9105320) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0003716) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2020-01-08 |