| NPI | 1407942097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA13565) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA PA13565) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2016-04-01 |