| NPI | 1194969717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60404649) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA152984) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2018-08-07 |