| NPI | 1144322835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60635636) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA161381) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-07-19 |