| NPI | 1396830824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA157225) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA18526) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60302715) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-09-10 |