| NPI | 1265009781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-2723) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61349330) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2024-05-08 |