| NPI | 1568744027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 55122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55122) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2018-10-24 |