| NPI | 1316585888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 1571543) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61117056) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-02-20 |