| NPI | 1124217112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19119) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01268) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2023-11-03 |