| NPI | 1396751764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 55417) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 705) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-06-30 |