| NPI | 1881979235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22481) | 
| 208800000X Urology (Licence: OR PA169800) | |
| Enumeration Date | 2011-10-17 | 
| Last Update Date | 2014-10-20 |