| NPI | 1972994267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 54113) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54113) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2021-02-02 |