NPI | 1316994452 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004947) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004947) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2021-05-25 |