| NPI | 1902906860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000127) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C50000127) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0001174) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-08-13 |