| NPI | 1710650940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA63739) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008678) |
| Enumeration Date | 2021-07-25 |
| Last Update Date | 2025-11-21 |