| NPI | 1902355753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA54090) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA178413) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2021-12-02 |