| NPI | 1730492935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20956) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 4648) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2018-01-18 |