| NPI | 1467862680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60824358) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60824358) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60824358) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2021-10-29 |