| NPI | 1851724538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4788) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2017-07-07 |