| NPI | 1063975753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 56843) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-11-02 |