| NPI | 1407398639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 56826) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 000919) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2022-02-16 |