| NPI | 1508377953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60417) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 021485) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2022-12-09 |