| NPI | 1245749613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60993199) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-06-20 |