| NPI | 1477688471 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004602) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004602) | 
| Enumeration Date | 2007-02-22 | 
| Last Update Date | 2022-01-12 |