| NPI | 1922689587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 61250) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2022-08-19 |