| NPI | 1760613343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1460) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NE 1460) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2011-04-15 |