| NPI | 1922051770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105268) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601002121) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-12-16 |