| NPI | 1598012908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63174) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0004719) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2024-03-15 |