| NPI | 1487706040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA OA60833423) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10005133) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-07-14 |