| NPI | 1336734789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 1661274) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61338060) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA61338060) | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2024-12-10 |