| NPI | 1740286293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 1089) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IA 2281) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2015-09-22 |