| NPI | 1265912570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57511) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7146) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 7146) | |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2020-02-13 |