| NPI | 1003175621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61030329) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363AS0400X Physician Assistant, Surgical (Licence: IA 002283) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2022-02-14 |