| NPI | 1912967779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56672) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01428) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-07-07 |