| NPI | 1306357496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61518146) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005315RX) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2025-02-13 |