| NPI | 1710238506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56681) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5935) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2019-05-15 |