| NPI | 1154903888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61420139) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61420139) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-09-28 |