| NPI | 1578225983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA70058492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9072) |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2026-02-09 |