| NPI | 1992044770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA23071) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA 0003643) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2022-01-05 |