| NPI | 1295229235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA 55765) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NH 1382) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2020-02-24 |