| NPI | 1043592512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57879) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015088) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2024-08-12 |