| NPI | 1891358016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59290) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 3854) |
| 363A00000X Physician Assistant (Licence: TN 3854) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2021-03-24 |