| NPI | 1861549396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-914) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD c0001509) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2014-04-14 |