| NPI | 1194159350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV 1628) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA PA23154) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2024-01-06 |