| NPI | 1558402065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62193) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011496-1) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-06-18 |