| NPI | 1619901188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21411) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 0505P) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-02-04 |