| NPI | 1801945829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OR PA221152) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA 23048) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2024-09-16 |