| NPI | 1942746144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 54128) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA 54128) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2019-11-04 |