| NPI | 1659692176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01594) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 10735) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2013-02-22 |