| NPI | 1407232754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA52635) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3400) |
| Enumeration Date | 2015-08-09 |
| Last Update Date | 2019-12-02 |