| NPI | 1376124651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA64140) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006885) |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2024-12-09 |