| NPI | 1326118274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 112011-8926) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18560) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-11-15 |