| NPI | 1689945933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53240) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA3756) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA53240) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2023-04-24 |