| NPI | 1518906494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA17128) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 14667) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2024-01-12 |