| NPI | 1215087630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004802) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA22204) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2013-03-14 |