| NPI | 1336716760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery (Licence: CA PA60460) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2021-12-13 |