| NPI | 1770910820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 52745) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5517) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2015-11-19 |