| NPI | 1538942057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64983) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 6289) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2024-11-21 |