| NPI | 1528546074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA57289) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT PENDING) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2019-12-18 |