| NPI | 1346774106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60921113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55210) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60921113) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2021-11-22 |