| NPI | 1518417476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60938034) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 6525) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2020-03-25 |