| NPI | 1134540941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61230443) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA0275) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2025-05-21 |