| NPI | 1619586153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61229907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61229907) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2026-01-16 |