| NPI | 1619252913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA 21818) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21818) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2023-03-07 |