| NPI | 1124571971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: WA PA60698213) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2021-07-23 |