| NPI | 1003103565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60511375) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054996) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60511375) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2022-06-02 |