| NPI | 1689142580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA62385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2018040346) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2023-06-11 |