| NPI | 1669002721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-1843) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA-1843) |
| 363A00000X Physician Assistant (Licence: ID PA-1843) | |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2023-11-01 |