| NPI | 1801538699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61271) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical | |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 61271) | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-09-20 |