| NPI | 1932386430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01271) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 1075995) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2016-06-22 |