| NPI | 1790278190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA60598) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA195774) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-10-03 |