| NPI | 1841437761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 1691) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1691) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2010-03-05 |