| NPI | 1013020809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA18058) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA18058) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 11170) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2025-11-24 |