| NPI | 1871905984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA51812) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA ma056706) |
| 363A00000X Physician Assistant (Licence: CA PA51812) | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2015-04-27 |