| NPI | 1932493665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: FL 11134) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 11134) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2011-05-27 |