| NPI | 1750725685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 22914) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: OR PA175553) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2016-03-09 |