| NPI | 1952472151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA13937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020093) |
| 363AS0400X Physician Assistant Surgical (Licence: CA PA13937) | |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2019-09-25 |