| NPI | 1720288087 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA CA21210) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA CA21210) | 
| Enumeration Date | 2007-07-24 | 
| Last Update Date | 2023-06-07 |