| NPI | 1467803965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA53506) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA53506) |
| Enumeration Date | 2016-06-26 |
| Last Update Date | 2022-08-30 |