| NPI | 1619740966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64709) |
| Additional Taxonomies | 208800000X Urology (Licence: CA PA64709) |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-11-01 |