| NPI | 1649357054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA22878) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR 1040100) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-12-04 |