| NPI | 1851584932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C03579) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C03579) |
| 363A00000X Physician Assistant (Licence: MD C03579) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2017-01-24 |