| NPI | 1013685932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60692) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 60692) | |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2023-11-08 |