| NPI | 1407363377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WA PA60891413) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1922) |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2024-05-24 |