| NPI | 1720620883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59558) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 59558) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2021-11-30 |