| NPI | 1396729349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60312114) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01006) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2012-11-01 |