| NPI | 1043603699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: DC PA200001802) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60748533) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2023-11-20 |