| NPI | 1669547972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA54089) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003181) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0003181) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-10-25 |