| NPI | 1184920407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52145) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0003373) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2017-03-22 |