| NPI | 1164793386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60686315) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2020-04-09 |