| NPI | 1134766868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 58002) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 58002) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2020-04-17 |