| NPI | 1134458961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61306178) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA06445) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2025-04-10 |