| NPI | 1851910012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57905) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA 57905) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2024-02-21 |