| NPI | 1912417122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA60594) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 021310) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-08-30 |