| NPI | 1417285818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3373) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PENDING) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2022-03-31 |