| NPI | 1033688981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60980474) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005568) |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2021-10-25 |