| NPI | 1386095339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA 57036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2016016697) |
| 363AS0400X Physician Assistant Surgical (Licence: TN 3820) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-06-26 |