| NPI | 1700927365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030322) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002757) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-06-13 |