| NPI | 1700944816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0005943) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0005943) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-08-11 |