| NPI | 1326438268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA 52079) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52079) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2022-05-17 |