| NPI | 1295144822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51747) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 51747) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 51747) | |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2022-11-23 |