| NPI | 1790024164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: NV 789491) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2017-04-25 |