| NPI | 1598935132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: MD C0003712) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MD C03712) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2010-09-16 |