| NPI | 1457343766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004752) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01058) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2013-09-27 |