| NPI | 1255403770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15603) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PA15603) |
| 208600000X Surgery (Licence: CA PA15603) | |
| 363AS0400X Physician Assistant Surgical (Licence: CA PA15603) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2023-01-10 |