| NPI | 1336587534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 5894) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA CA23020) |
| 363A00000X Physician Assistant (Licence: TN 5894) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2024-10-16 |