| NPI | 1447592266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA201320) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA PA22834) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2021-07-22 |