| NPI | 1598346272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61158239) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WA PA61158239) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2025-04-16 |