| NPI | 1528484490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60837693) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05348) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2018-05-03 |