| NPI | 1417168527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60694643) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001579) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2016-10-28 |