| NPI | 1114419280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0007515) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60839895) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-06-14 |