| NPI | 1952402547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA30031) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002000) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-11-01 |