| NPI | 1992278204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA56337) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 56337) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2022-01-03 |