| NPI | 1518931476 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15253) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3147) | 
| Enumeration Date | 2006-02-15 | 
| Last Update Date | 2023-01-13 |