| NPI | 1568799054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA150467) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60120088) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2017-02-17 |