| NPI | 1518183573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19032) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA PA19032) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-10-30 |