| NPI | 1104446640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 58725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58725) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-06-01 |