| NPI | 1184393456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61352492) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WA PA61352492) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2023-05-09 |