| NPI | 1457902694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7976) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA57137) |
| 363AS0400X Physician Assistant Surgical (Licence: AZ 7976) | |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2023-04-05 |