| NPI | 1326530452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60875571) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2019-03-20 |