| NPI | 1639772981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 65233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025496) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 65233) | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2025-12-23 |