| NPI | 1538551288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61122674) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 99066180A) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2021-02-22 |