| NPI | 1174800031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA169154) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60320459) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2015-12-28 |