| NPI | 1265553853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA12672) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 009567) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-03-19 |