| NPI | 1659743623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61678121) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0006009) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2025-11-10 |