| NPI | 1730468265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21644) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7426) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2020-05-11 |