| NPI | 1477096535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60854540) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020306) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2018-10-02 |