| NPI | 1215698006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61621793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028920) |
| 363A00000X Physician Assistant (Licence: WA PA61621793) | |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2025-05-02 |