| NPI | 1801210364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: 13-577) |
| 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: DC SA0124) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2015-12-02 |