| NPI | 1497217558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61012234) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 61012234) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2022-11-18 |