| NPI | 1609894369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA 10004020) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA 22640) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-11-06 |