| NPI | 1144523473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR 172044) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA 60615487) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2022-12-09 |