| NPI | 1790716074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA15541) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA15541) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-12-02 |