| NPI | 1093707440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10003016) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA00387) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-11-29 |