| NPI | 1528521408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62923) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 4479) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 4479) | |
| 363A00000X Physician Assistant (Licence: CT 4479) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-02-07 |