| NPI | 1578328043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA64093) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: PA64093) |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-06-13 |